Provider Demographics
NPI:1386200368
Name:WIELAND, ADELIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ADELIA
Middle Name:
Last Name:WIELAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28419 CANELO LOOP
Mailing Address - Street 2:
Mailing Address - City:RIO HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78583-3511
Mailing Address - Country:US
Mailing Address - Phone:956-752-1212
Mailing Address - Fax:
Practice Address - Street 1:2712 XAVIER
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2179
Practice Address - Country:US
Practice Address - Phone:956-752-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX541291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical